The world is ageing. Current evidence demonstrates how the UK need for palliative care will increase by 42 per cent by 2040. [1] Care homes are projected to be the most common place of death [2] with similar figures expected globally.[3]It is therefore important that living environments are designed to optimise function, quality of life and independence for an increasingly frail population. Technological and architectural innovations offer great potential to improve quality of life, to enable people to live in their homes for longer. [4]

Futurism is an interdisciplinary field combining mathematics, engineering, art, technology, economics, design, history, geography, biology, theology, physics, and philosophy. Futurists collect data, identify emerging trends, develop strategies, and calculate the probabilities of various scenarios occurring in the future. Forecasts are used to help leaders make better, more informed decisions.[5] We believe it is possible to use futurism to determine how various factors (such as technology, design and architecture) can be used to support palliative care in the future.

On 12 November 2018, 50 delegates attended theinaugural Palliative Care, Architecture and Design Symposium (PADS) in the University of Liverpool (funded by engage@liverpool, University of Liverpool). We applied futuristic thinking to palliative care through a collaborative meeting of academics, clinicians, and the public, to discuss ideas related to design and future provision of palliative care. The following are some of the key ideas arising from the symposium.

The symposium included multiple presentations on the role of VR, robotics, and other new technologies. These tools have the potential to improve care through therapeutic, assistive, communication and social purposes. However, it is also possible that these technologies may replace some human contact, resulting in job losses, and decreased contact with healthcare professionals, and increased elderly social isolation. For public health there is concern that technological investment will replace other societal initiatives.Consequently, research on the opportunities and risks of this technology is urgently needed. [4]

Transdisciplinary Teams

There was discussion that in order for palliative care to benefit from new innovation, that it was important to explore alternative teamwork approaches. This may include transdisciplinary models, which may help to harmonize knowledge between disciplines into a coordinated and coherent whole.[6]

Inequalities in Palliative Care

It is essential to ensure new technology will meaningfully benefit society and not widen existing health inequalities. [4] Adopters of new technology are generally younger, and more affluent than non-adopters; therefore, it is possible that societal access to these technologies will not be equitable.Consequently, it is imperative to consider these health and social inequalities when designing and implementing new tools.

The Design of Spaces

The spaces where we provide and receive palliative care affect that care. We must carefully consider design of new healthcare environments, in order to identify our own assumptions and biases about design, and question how those spaces might help or hinder palliative care. It is important that human-centred design methodology informs the design of living, communal and social spaces for those receiving palliative care. [7]

These are just a few of the themes from the presentations and discussions. The shared excitement and resolve to collaborate were encouraging. There was consensus that we also need more opportunities and spaces that allow for this exchange of ideas.